Welcome to the Allied Health Profession’s webinar:

Professionalism:The Big Conversation

29th January 2013#bigSLTtalk

PROFESSIONALISM:THE BIG CONVERSATION

Kamini Gadhok MBE CEO, RCSLT

CONTEXT

First Francis Inquiry into Mid-Staffs (2010) Winterbourne View Hospital Inquiry (2011) Karen Middleton, CHPO, set up working group All AHPs encouraged to provide leadership for the

‘Big Conversation’ on professionalism Second Francis Inquiry Report due for release

6th Feb 2013 Webinar: Opportunity for AHPs to hear from key

leaders to support the Big Conversation

WEBINAR FORMAT

Presentations Karen Middleton Julia Scott Anna van der Gaag Q&A

Professionalism and the Big Conversation

Karen Middleton

Chief Health Professions Officer, England

Mid Staffs Public Inquiry:What went wrong?

The first inquiry found:• A failure of clinical and managerial professionalism and fundamental

human compassion• Patients – especially older people – denied nutrition, hygiene and

basic dignity and subjected to degrading and unsafe treatment• A closed culture with a bullying management style that sought to

ignore or suppress concerns• Inward looking medical and nursing communities, disengaged from

management• FT status and financial savings were pursued at the expense of

providing high quality, safe care to its patients• Too few qualified nurses and disproportionate reliance on healthcare

assistants• Poorly thought through clinical reconfiguration

My personal journey

• Where to locate the blame?• Utter horror and shame• How did clinical professionals allow this to

happen and how do we prevent it happening again?

• Where are AHPs in this?• Winterbourne• Culture and the need to talk• The Big Conversation – possibly the most

important thing we’ll ever do.

Professionalism:The Big Conversation

Julia Scott CEO, College of Occupational Therapists

6 Commonplace Characteristics of Professions

1. A Commitment to serve in the interest of clients, in particular, and the welfare of society in general

2. A body of theory or knowledge3. A specialist set of professional skills, practices and performances that

are unique to the profession4. The capacity to make judgements with integrity under conditions of

technical and / or ethical uncertainty5. An organised approach to learning from experience and thus of growing

new knowledge from the context of practice6. The development of a professional community responsible for oversight

and monitoring of quality in both practice and professional education

(Gardner, Howard and Shulma, Lee S “The Professions in America Today” Daedalus 134 (summer 2005)

The Distinctive Characteristics of Professional Services?

• Professional Services do not have a fixed specification that can be easily judged

• Clients often do not know what they want or require, until advised by the professional

• The professional tends to know more about the quality of the service provided than the client does

• Those on the receiving end of professional services may be considered vulnerable as they have less information than the professional

• Users of services cannot judge competency or whether the professional has done a good job. Tensions between the professional and the user create what is known as “Information Asymmetries”

PARN (The Professional Associations Research Network)

Promoting professionalism

Anna van der Gaag, Chair, HCPC

Professionalism debate29 January 2013

Outline

• Increased focus on professionalism in UK

• HCPC research findings

HCPC: who do we regulate?308,000* registrants from 16 professions (*estimated)

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

Rise in complaints in the UK

2007 2008 2009 2010 20110

2000

4000

6000

8000

10000

5168

8781

1624

4211

424925

General Medical Council Nursing and Midwifery CouncilHealth and Care Professions Council

Competence versus conduct HCPC data 2011-12

8%

29%

63%

competence conduct mixed grounds

HCPC’s Research on professionalism

• Qualitative study with students and educators

• Explored perceptions of professionalism

• Three professions – paramedic, occupational therapy and podiatry

• University based programmes

• Focus groups and interviews (n=115)

• Second part of the study looking at measurement of professionalism

Study Outcomes

Themes• Professionalism = a judgement

• A holistic concept

• A set of behaviours determined by context

No differences between professions

A tough nut to crack

Research from• Sweden• Netherlands• United States

Common theme….Peer led discussion and peer feedback is a key influence on behavior and self awareness

Conclusions

• Professionalism a judgement, influenced by context

• Key influence on your professionalism are your peers

• Peer led conversations are an important part of the change

References

Bergman, D, Arnetz, B, Wahlstrom, R, Sandahl,C. (2007) Effects of dialogue groups on physicians work environment. Journal of Health Organization and Management 21(1) p27-38.

HCPC (2011) Fitness to Practise Annual Report. www.hcpc-uk.org

HCPC (2011) Professionalism in healthcare professions. www.hcpc-uk.org Hickson, G. et al. (2007) A complementary approach to promoting professionalism. Academic Medicine, 82 (11) p1040-1048.

Leistikow, I, Kalkman, C, De Bruijn,. (2011) Why patient safety is such a tough nut to crack. British Medical Journal, 342;d3447.

ANY QUESTIONS?